Etiology and risk factors for scholastic backwardness in children – A retrospective study

Abstract

Background: Scholastic backwardness (SB) is estimated to affect 20–50% of schoolgoing children in India. The etiology includes low intelligence quotient (IQ), attention deficit hyperactivity disorder, specific learning disabilities (SLD), and chronic illnesses. Non-cognitive factors such as poor parenting, marital disharmony, and sibling rivalry could also affect learning. Early recognition and prompt remediation could obviate its negative impact on a child’s self-esteem and achievements. Objective: The objective of the study was to study the etiology and risk factors for SB in children. Materials and Methods: This hospital-based retrospective study was done in the child guidance clinic of the Department of Pediatrics of a Tertiary Care Teaching Hospital in Karnataka. The records of children age 5–16 years, visiting the SB unit from January 2011 to January 2019, were reviewed. Children fulfilling the case definition of SB were included in the study and classified based on IQ, attention span, and performance on NIMHANS scale for SLD. The risk factors for SB were also assessed. Results: Among the 286 children with SB, the causes identified were attention deficit disorder (ADD) (4.5%), ADD with SLD (30.4%), SLD (24.1%), slow learners (SL) (20.6%), intellectual disability (ID) (3.1%), and others (17.1%). Consanguinity, developmental delay, seizure disorder, and lower educational status of parents were strongly associated with low IQ. Birth by cesarean section was associated with ADD. Psychosocial risk factors included disturbed home environment, poor parenting techniques, and poor relation with teachers and peers. Conclusion: SLD, ADD, SL, and ID are the major causes of SB. Disturbed relations with parents, peers, and teachers can also contribute to SB.